Exam 3 CNS Flashcards
What is GFAP?
Glial fibrillary acidic protein. it is a protein that astrocytes make when injury detected in the brain
T/F GFAP is collagen
False
What is the function of oligodendrocytes?
to myelinate axons and provide insulation to propogate action potential going down the axon
These cells are resident macrophages of the brain
a. oligodendrocytes
b. astrocytes
c. neurons
d. microglial cells
D. microglial cells
What is the function of microglial cells:
To clear damage - phagocytic and they migrate to areas of damage
when there is damage, they proliferate
What does a stroke look like on stain?
very large amount of cytoplasm and bulbbly because full of lipid material = full of myelin
If the BBB is damaged, what happens to the brain
it swells
What are the two types of brain swelling?
Vasogenic Cerebral Edema
Cellular/ Cytotoxic Cerebral Edema
Tx of vasogenic cerebral edema?
Mannitol or Decardon
This type of edema is caused by fluid entering the extracellular space
a. vasogenic cerebral edema
b. cellular cerebral edema
a
What is vasogenic cerebral edema associated with?
a. brain tumor
b. stroke
c. hypertension
d. brain abscess
e. A and D
E
This is an untreatable form of cerebral edema
becasue it occurs intracellularly:
a. vasogenic cerebral edema
b. cellular cerebral edema
B.
What is cellular cerebral edema associated with?
a. brain tumor
b. stroke
c. hypertension
d. brain abscess
e. A and D
B. stroke
If a person has a mixture of both vasogenic and cellular cerebral edema, will mannitol treat their condition?
a. No
b. yes no matter when they are treated
c. yes, only in the early stages
C. early stages
What is a possible complication of when the brain over-swells?
transtentorial herniation
T/F The brain, like most other organs, has a lymphoid drainage system
False, no draining of lymph
What is hydrocephalus?
build up of CSF in the lateral and 3rd ventricles
T/F the brain has no glycogen stores
TRUE
How long does it take you to lose consciousness if you are deprived of oxygen?
a. 15-20 seconds
b. 1-2 minutes
c. 3-4 minutes
d. 5-6 minutes
e. 10 minutes
A. 15- 20 seconds
At what point do you start losing neurons?
a. 15-20 seconds
b. 1-2 minutes
c. 3-4 minutes
d. 5-6 minutes
e. 10 minutes
B
How many ml of O2 per minute do nuerons require?
a. 500-600
b. 75-100
c. 300-400
d. 1000-2000
A
This is defined as arrest of or inadequate blood flow
a. anoxia
b. hypoxia
c. ischemia
d. eosinophilic degranulation
C. ischemia
This is defined as the absence of oxygen:
a. anoxia
b. hypoxa
c. ischemia
d. eosinophilic degranulation
A.
This is defines as reduced oxygen supply:
a. anoxia
b. hypoxa
c. ischemia
d. eosinophilic degranulation
B
How many neurons does the brain have?
100 billion
How much does the brain weigh?
2.5 pounds
This is defined as a sudden loss of neurologic function related to a problem with the cerebral vascular supply
Stroke
What are the two types of stroke
ischemic + hemorrhage
T/F Each 100 g of brain tissue must receive 50 ml of blood per minute
True
What is the difference between an ischemic and a hemorrhagic stroke?
a. A hemorrhagic stroke is when there is too little blood and an ischemic stroke is when blood is leaving the vascular spaces
b. A hemorrhagic stroke is when blood is leaving the vascular spaces and an ischemic stroke is when there is too little blood
c. there is no difference between the two
B
T/F Stroke is the leading cause of long term disability
True
When the brain is only getting 20 ml/100g, what does the EEG look like?
a. normal
b. amplitude increased
c. amplitude decreased
d. isoelectric
e. absent
C
When the brain is getting 15ml/100g, what does the EEG look like?
a. normal
b. amplitude increased
c. amplitude decreased
d. isoelectric
e. absent
D. isolectric aka no waves, no evoked cortical response & absent electrical activity
In terms of large hemispheric strokes, what is the most common artery that is affected?
a. anterior cerebral
b. middle cerebral
c. posterior cerebral
d. all the same
B middle
These are slit like infarcts that are small and typically arise in the basal ganglia (caudate + putamen) that may ALSO occur in the pons in pts with diabetes or hypertension.
a. embolic infarcts
b. lacunar infarcts
c. thrombus in left auricle
d. none of the above
B. lacunar
Which of the following are common sources of cerebral embolism?
a. ulcerative atherosclerosis of the common + internal carotid arteries
b. thrombus in the left auricle in pts w a fib
c. acute bacterial endocarditis
d. all of the above
e. none of the above
D.
These infarcts are peripheral in nature, tend to be multiple + hemorrhagic and can arise from many different sources
a. embolic infarcts
b. lacunar infarcts
A. embolic
Subarachnoid hemorrhages occur :
a. between dura mater + skull
b. between dura + epicure
c. between dura + pia mater
d. between pia mater + arachnoid mater
D
most common cause of subarachnoid hemorrhages?
berry aneurysms in the circle of willis
Berry aneurysms are related to a defect where?
in the INTERNAL elastic lamina
T/F Berry aneurysms usually appear as one lesion
False, frequently multiple
This type of aneurysm is due to the rupture of blood vessels in the parenchyma of hte brain that quikcly ruptures into the ventricular system and kills the patient
a. subarachnoid hemorrhage
b. Primary Intracerebral Hemorrhage
b. Primary Intracerebral Hemorrhage
What is the true prevention of Primary Intracerebral Hemorrhages?
Decreased BP!!!
What is the 3rd most common cause of death and leading cause of long term neurologic disability?
Stroke
T/F Berry aneurysms are related to defects in the vessel wall that are probably developmental in nature
TRUE! probably born with it and then it develops in hte mid 20s
What is the primary tumor of the brain?
Astrocytoma (which is a glioma (tumor of glial cells))
A glioblastoma is:
a. low grade
b. medium grade
c. high grade
C high grade
This ring contrast enhacement is seen on a CT or MRI scan and is evident of what?
a. glioblastoma
b. medulloblastoma
c. meningioma
d. none of hte above
Glioblastoma! used to diagnose!
What is the tx of glioblastomas?
surgery, chemo or radiation but these are last months, not years
This is a rapidly growing tumor that commonly occurs around the 4th ventricle, causing hydrocephalus
a. glioblastoma
b. medulloblastoma
c. meningioma
d. primary cerebral lymphoma
e. acoustic neuroma/schwannoma
b. medulloblastoma
This type of tumor may arise anywhere in the cerebrum, cerebellum or brainstem + is composed primarily of B cells. A HIGH percentage is caused by EBV, survival rate is 3-4 years
a. glioblastoma
b. medulloblastoma
c. meningioma
d. primary cerebral lymphoma
e. acoustic neuroma/schwannoma
D
This is a common, slow growing , non invasive type of tumor that typically presents with seizures. On MRI psammoma bodies are seen
a. glioblastoma
b. medulloblastoma
c. meningioma
d. primary cerebral lymphoma
e. acoustic neuroma/schwannoma
C. meningioma
Since these type of tumors dont invade, surgery is the mainstay of treatment for them
a. glioblastoma
b. medulloblastoma
c. meningioma
d. primary cerebral lymphoma
e. acoustic neuroma/schwannoma
C
This tumor can give rise to hyperostosis of overlying skull and is more common in females in the 7th decade
a. glioblastoma
b. medulloblastoma
c. meningioma
d. primary cerebral lymphoma
e. acoustic neuroma/schwannoma
C. meningioma
This tumor arises in the vestibular division of hte 8th nerve that causes unilateral deafness
a. glioblastoma
b. medulloblastoma
c. meningioma
d. primary cerebral lymphoma
e. acoustic neuroma/schwannoma
E
How do you diagnose schwannomas?
a. CT
b. XRAY
c. MRI
d. H&P
c. MRI
What is the MOST common site of metastasis to the brain? A. Lung b. breast c. melanoma d. thyroid e. kidney
LUNG!!!!!!!!!!!!